Extreme constipation - advice needed

[Anonymous]

What you are seeing are fecalomas - dried, old feces. I imagine your child says their tummy hurts and they have alternating diarrhea and constipation. We found out belatedly that this is common with high functioning aspergers, as well as late toilet training, both of which we experienced. I would suggest you see a good pediatric gastroenterologist. We saw Dr. Sirlin in Ashburn, VA and the first thing he did was order the x-ray. We could see all the fecalomas lined up in DS's large intestine. He ordered a full "clean out" and then a recheck. DS is now on miralax daily. He said some of the fecalomas could have been in DS for years. Our pediatrician never caught it. DS's large colon is permanently distended. You need to get this taken care of pronto.

[Anonymous]

Anonymous wrote:What you are seeing are fecalomas - dried, old feces. I imagine your child says their tummy hurts and they have alternating diarrhea and constipation. We found out belatedly that this is common with high functioning aspergers, as well as late toilet training, both of which we experienced. I would suggest you see a good pediatric gastroenterologist. We saw Dr. Sirlin in Ashburn, VA and the first thing he did was order the x-ray. We could see all the fecalomas lined up in DS's large intestine. He ordered a full "clean out" and then a recheck. DS is now on miralax daily. He said some of the fecalomas could have been in DS for years. Our pediatrician never caught it. DS's large colon is permanently distended. You need to get this taken care of pronto.

NP. How awful for your child! Thanks for warning of a potential problem I'd never have thought of.

[Anonymous]

Metamucil makes cookies. My son with autism will eat these. They really help!

[Anonymous]

Anonymous wrote:What you are seeing are fecalomas - dried, old feces. I imagine your child says their tummy hurts and they have alternating diarrhea and constipation. We found out belatedly that this is common with high functioning aspergers, as well as late toilet training, both of which we experienced. I would suggest you see a good pediatric gastroenterologist. We saw Dr. Sirlin in Ashburn, VA and the first thing he did was order the x-ray. We could see all the fecalomas lined up in DS's large intestine. He ordered a full "clean out" and then a recheck. DS is now on miralax daily. He said some of the fecalomas could have been in DS for years. Our pediatrician never caught it. DS's large colon is permanently distended. You need to get this taken care of pronto.

Hi. OP here. Would the radiologist have know whether the poop on the X-ray was "fresher" or fecalomas? I will ask the pediatrician what was in the report tomorrow morning. Our son's case is more recent in origin. He had a bad bout of diarrhea caused by an infection, and then stopped being as regular as he normally is. His poops are still soft and easy to pass (sorry if TMI) but there is a very very large amount of it all up and down his colon that we need to get out. We have done sennakot and miralax today, without an appreciable change. PP, please post on how you did the clean out. Thank you.

[Anonymous]

Enema as a starting point. Miralax and LOTS of water.

[Anonymous]

I have given my 4 year old an enema and it was pretty awful. She hated it and cried and I really hesitate to do it again. I have since given glycerin suppositories a few times, which she also hates but tolerates better. The enema seemed to cause a lot of tummy cramping until she passed a huge stool. The glycerin didn't have that impact, though it also wasn't as effective.

[Anonymous]

Is it important that the kid drinks plain water? DS will drink a lot of water with lemon/honey in it, etc. Or 1/2 water, 1/2 juice. But he is very averse to plain water at the moment so hoping that that does not make a difference.

[Anonymous]

I don't really understand what is so bad about an enema. The water should make it so the stool isn't uncomfortable to pass.

[Anonymous]

go to the grocery store....Safeway definitely has this....and get some Smooth Moves Tea. It is a detox tea that will get the bowels moving. Make sure to drink lots of water after the tea because it can cause cramping if you are dehydrated.

This tea works beautifully.

[Anonymous]

Please don't give Miralax...it's dangerous.

http://www.gutsense.org/gutsense/the-role-of-miralax-laxative-in-autism-dementia-alzheimer.html

[Anonymous]

Anonymous wrote:I don't really understand what is so bad about an enema. The water should make it so the stool isn't uncomfortable to pass.

I posted before about giving my 4 yr old an enema. It seemed like when the water was in her colon (right? yes i know i need to learn more about this) she was having a lot of cramping and her stomach was making a rumbling sound. It was the cramping that seemed painful, passing the stool wasn't so bad.

[Anonymous]

Anonymous wrote:

Anonymous wrote:What you are seeing are fecalomas - dried, old feces. I imagine your child says their tummy hurts and they have alternating diarrhea and constipation. We found out belatedly that this is common with high functioning aspergers, as well as late toilet training, both of which we experienced. I would suggest you see a good pediatric gastroenterologist. We saw Dr. Sirlin in Ashburn, VA and the first thing he did was order the x-ray. We could see all the fecalomas lined up in DS's large intestine. He ordered a full "clean out" and then a recheck. DS is now on miralax daily. He said some of the fecalomas could have been in DS for years. Our pediatrician never caught it. DS's large colon is permanently distended. You need to get this taken care of pronto.

Hi. OP here. Would the radiologist have know whether the poop on the X-ray was "fresher" or fecalomas? I will ask the pediatrician what was in the report tomorrow morning. Our son's case is more recent in origin. He had a bad bout of diarrhea caused by an infection, and then stopped being as regular as he normally is. His poops are still soft and easy to pass (sorry if TMI) but there is a very very large amount of it all up and down his colon that we need to get out. We have done sennakot and miralax today, without an appreciable change. PP, please post on how you did the clean out. Thank you.

PP above back. I actually don't know the answer to that. Here is the wiki on fecalomas. http://en.wikipedia.org/wiki/Fecaloma. The day we found out about DC's situation was a very dark day for me. I had no idea what had been going on in DC's system. He would complain of tummy aches and then go sit on the potty for long periods of time. He could never tell me whether or not what he was experiencing was diarrhea or constipation (turns out it is both - as the fecalomas work their way through, he experiences constipation. The diarrhea occurs when liquid fecal material (sorry) works its way around the fecalomas. We got a very delayed asperger diagnosis and our pediatrician never picked up on the issues. The only GI work done on DC was an upper and lower G.I., a Celiac disease test, and a lactose intolerance test. No one thought to X-ray DC's intestine. I had never even heard the work "fecaloma" before we had the x-ray. Even I, a non-radiologist, could see the fecalomas marching up, across and down the large intestine.

The way I found Dr. Sirlin was by calling the top research on Asperger gut issues in the USA (Boston Children's) and he gave me Dr. Sirlin, a pediatric gastroenterologist. I now realize he sees this daily but to us and to our pediatrician, DC's tummy problems were a mystery. It was a great relief to find out what was causing our DC so much distress BUT we were years late in catching it. Some literature says these things calcify and can be in the intestine for years. They can also cause life-threatening conditions if they break through the colon. If you get an appointment with your pediatrician, be sure to take the x-ray with you. A good gastroenterologist should not want to take many films because the child is growing and one doesn't want to expose the reproductive organs to x-rays. We did the first x-ray, which was exactly what Dr. Sirlin predicted. We did a "flush out". Then another x-ray to make sure all the fecalomas were finally gone. However, they can come back. So now we see Dr. Sirlin every six months for a check - he can usually palpate the area and determine through a rectal check if the child has impacted fecalomas.

I did ask him how many years he thought they had been in DC. He said it was hard to tell but it could have been as long as five. I think he was trying to make DH and me feel better because DS was 17 by then. We had missed all the signs. There is a lot of literature on the internet about fecalomas and Aspergers and autism. There is also a name for the condition where the child experiences "leaks" but I can't remember the name of it - that occurs when fecal matter is trying to be pushed out by an already extended colon around the fecalomas. So the child has accidents. That's part of the syndrome but I can't remember the name off the top of my head.

[Anonymous]

sorry. don't put a period on the end. Here's the wiki cite again: http://en.wikipedia.org/wiki/Fecaloma